Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.95233
Revised: May 31, 2024
Accepted: June 26, 2024
Published online: September 18, 2024
Processing time: 117 Days and 2 Hours
Hypothermic machine perfusion (HMP) has demonstrated benefits in terms of early kidney transplant function compared to static cold storage. While longer preservation times have shown detrimental effects, a previous paired study indicated that longer pump times (the second kidney in a pair) might lead to improved outcomes.
To revisit the prior paired study's somewhat unexpected results by reviewing our program's experience.
A total of 61 pairs of transplant recipients who received kidneys from the same donor (2012-2021) were analyzed. Patients were divided into two groups depending on whether they were transplanted first (K1) or second (K2). Therefore, the patients in each pair had identical donor characteristics, except for time on the pump. Statistical analyses included Kaplan-Meyer analysis and paired tests, including McNemar's test, student's paired t-test, or Wilcoxon's test, as appropriate.
The two groups of recipients had similar demographics (age, body mass index, diabetes, time on dialysis, sensitization and retransplants). Cold ischemic times for K1 and K2 were 8.9 (95%CI: 7.9, 9.8) and 14.7 hours (13.7, 15.8)
Our results agree with a previous study that suggested possible advantages to longer pump times. Both studies should encourage further research into HMP's potential anti-inflammatory effect.
Core Tip: Our study assesses the impact of longer hypothermic machine perfusion (HMP) times on kidney transplant outcomes using a matched pair analysis of 61 kidney pairs. Our results agree with previous findings, showing that the second kidney, subjected to longer HMP times, has improved freedom from biopsy-proven acute rejection within the first year. These outcomes suggest that extended HMP durations, when applied judiciously, may confer anti-inflammatory benefits. This supports the potential for further basic science research and future optimization of perfusion protocols.